Individual
KYLE DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1972 US HIGHWAY 431, BOAZ, AL 35957-5901
(256) 593-0495
Mailing address
124 WOLF CREEK TRL SW, HUNTSVILLE, AL 35824-3506
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17345
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17345
STATE PHARMACY LICENSE
AL
Enumeration date
07/11/2020
Last updated
07/11/2020
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